The Plasma Pen is advertised as a gentle alternative to eyelid lifting: no surgery, no incision, no hospital. For some conditions, this is a realistic promise. For many others, it is one that cannot be kept – and then, in the end, you are left with a disappointment that is harder to correct than the original condition.

This article explains how the procedure actually works, who is a suitable candidate, what happens during the healing phase, and how to recognize a reputable provider.

What is a Plasma Pen treatment?

The Plasma Pen is a pen-shaped device that does not touch the skin. A tiny electric arc – ionized air, i.e., plasma – is created between the tip of the device and the surface of the skin. This spark produces a pinpoint, superficial heat injury on the skin.

The skin immediately contracts at this point. In the following days, a small brown dot forms, a scab that falls off after about a week. The actual effect takes place underneath: wound healing stimulates the formation of new collagen. Over weeks to months, the tissue tightens.

Treatment is usually carried out in a grid of dots over the area to be tightened – on the upper eyelid, on the lower eyelid, in the frown line, or on the upper lip.

Important to understand: No skin is removed. The Plasma Pen shrinks existing skin. This is the crucial difference compared to an eyelid lift – and this is where all the limitations of the procedure arise.

Who is suitable for the Plasma Pen

The procedure is realistically suitable for:

• mild skin excess with still good elasticity

• fine wrinkles, such as on the lower eyelid or upper lip

• younger to middle-aged groups with a fair skin type

• patients who accept a gradual, subtle change and plan for multiple sessions

It is not suitable for:

• pronounced skin excess hanging over the eyelid

• sagging skin with low elasticity

• protruding fat pads on the lower or upper eyelid – these cannot be repositioned with heat

• darker skin types, due to the significantly increased risk of permanent pigment changes

• a tendency to form keloid scars

• fresh tan or an upcoming sunny vacation

The most common reason for unsatisfactory results is not the device, but an incorrect indication: anyone with real excess skin who receives dot treatments will see a slightly altered, but essentially unchanged eyelid afterwards – after several sessions, several weeks of healing, and corresponding costs.

How long does healing take?

This is the most frequently underestimated aspect of the procedure. "Non-surgical" does not mean "no downtime" here.

Day 1 to 2. Marked swelling, especially on the upper eyelid. The treated dots are visible, and the skin feels tight and stings slightly.

Day 2 to 3. Swelling usually peaks. For treatments on the eyelids, it can be so pronounced that it is more difficult to open the eye.

Day 3 to 7. The dots dry into small dark crusts. These are visible and can hardly be covered with makeup at this stage. They must not be scratched off – this is exactly what causes scars and pigment spots.

Day 7 to 14. The crusts gradually fall off. Underneath, the skin is pink and sensitive.

Week 2 to 8. The redness gradually fades. Sun protection is not optional during this phase, but crucial – UV radiation on freshly healed dots is the most common cause of permanent pigment spots.

Month 2 to 3. The result of collagen formation becomes visible. Multiple sessions at intervals of several weeks are often necessary.

So do not plan for just two days of downtime, but rather for one to two weeks of visible healing and several weeks of redness.

What are the risks?

The Plasma Pen creates controlled heat damage. How controlled it is depends entirely on the experience of the practitioner. Possible complications include:

• Pigmentation changes – darker or lighter spots at the treated points, sometimes permanent. The most common undesirable result.

• Scarring if applied too intensely or if crusts are removed prematurely

• Infections of the open dot wounds

• Persistent redness lasting for months

• Uneven result if the grid of dots was applied unevenly

• For treatments close to the eye: injuries to the eyelid margin and cornea if not properly protected

The last point deserves emphasis. Eyelid skin is the thinnest skin on the body, and the eye lies directly underneath. A Plasma Pen treatment on the eyelid is not a cosmetic wellness appointment, but a procedure on a highly sensitive structure.

How to recognize a reputable provider

In Germany, the Plasma Pen is also offered outside of medical practices – in beauty salons and by providers without medical qualifications. This is not legally impermissible in every case, but it explains a large portion of the bad experiences.

Pay attention to:

A consultation with assessment. Anyone who offers you the treatment without having checked the skin's elasticity and assessed the excess skin cannot know whether the procedure will work for you.

An honest statement about suitability. A reputable provider will tell you if the Plasma Pen is not sufficient for your condition – even if it means losing an appointment.

Written information about risks, particularly regarding pigmentation changes and the actual healing duration.

Clarity about the number of sessions and the total cost before the first treatment.

A medical qualification for treatments on the face and eyelids.

A warning sign is the combination of heavily advertised before-and-after results and a very low starting fee. By the way: in Germany, advertising before-and-after images for surgical plastic-reconstructive procedures is prohibited. Anyone who advertises with them is at least operating in a gray area.

Plasma Pen or eyelid lift?

This question can be answered more clearly than it might initially seem. Two things are decisive: how much excess skin is present and how elastic it still is. A comparison with an upper eyelid lift highlights the differences.

A simple rule of thumb: if the eyelid skin visibly hangs over the eyelid crease or touches the eyelashes, the excess skin is too great to be shrunk. In this case, the Plasma Pen is the wrong method – regardless of how many sessions are scheduled. If the issue is on the lower eyelid, a lower eyelid lift is the path that will actually resolve the condition.

For fine wrinkles and still firm skin, on the other hand, it can be exactly the right choice – just like other skin treatments to improve skin texture and elasticity.

What applies in your case can be determined in just a few minutes of examination. Checking eyelid tension is part of every consultation regarding the eye area at our clinic.

Consultation at the FORUM Klinik

We will look at your condition and tell you which procedure suits your skin – and which does not. Sometimes that is the Plasma Pen. Often it is an eyelid lift. And occasionally, the honest answer is that nothing is needed yet. You are welcome to arrange a personal consultation.

Frequently Asked Questions

How long does the result of a Plasma Pen treatment last?

This depends on the condition of the skin and age. The newly formed collagen remains, but natural skin aging continues. For suitable indications, the result is usually expected to last for several years – it is not a permanent solution.

How many sessions are necessary?

For fine wrinkles, one session may be sufficient. For slightly more pronounced conditions, two to three sessions at intervals of several weeks are usually standard. Anyone who gives you a number without an assessment is guessing.

Is the treatment painful?

Treatment is generally carried out using an anesthetic cream. Most people describe a burning or stinging sensation. For many, the tightness in the first few days afterwards is more unpleasant than the treatment itself.

Can I go back to work immediately afterwards?

Physically possible, yes – but it is clearly visible. The small crusts remain for about a week and cannot be covered with makeup during this time. Plan the appointment accordingly.

Am I allowed to remove the crusts?

No. This is the most common mistake and the most frequent cause of permanent pigment spots and scars. The crusts must fall off on their own.

What happens if I sit in the sun?

Freshly healed dots react strongly to UV radiation. Without consistent sun protection for several weeks, the risk of permanent dark spots is significantly increased. This is the main reason why treatment before a beach holiday is discouraged.

Does the Plasma Pen help with hooded eyes?

If they are very mild with still good skin elasticity, it can bring a subtle improvement. With a true hooded eyelid hanging over the eyelid crease, shrinking the skin is not sufficient – in this case, an upper eyelid lift is the procedure that actually resolves the condition.